Surrounded by a depressing cocktail of shantyland and industria, its dark corridors almost endless and with stray goats grazing at its doorstep in the menacing Friday night shadow of gangsters, Port Elizabeth’s Dora Ngiza hospital is where babies are turned away to die.
Every day at the hospital, battling to stretch limited finances and resources, at least two babies are diagnosed with Aids. They are admitted for treatment only once and then restricted to outpatient care to make way for children with illnesses that can be cured.
After heading the hospital’s paediatric ward for 11 years and one of only three permanent staff, Dr Iwan Bekker spoke out this week after the ward’s Aids fatality rate of one a year seven years ago rapidly increased over the past two years to up to two deaths a week because it does not have anti-retroviral drugs like AZT.
“We can only treat the secondary infection, but that’s like treating hypertension with a headache tablet,” Bekker says. “We have a limited budget, so when a baby gets bad, like pneumonia, we won’t admit it for the second time. We tell the mother to take it home and let it die.”
Bekker, who says two new HIV-positive babies are admitted to Dora Ngiza every day for the “horrible thing” that is diagnosis, adds: “If we admitted all Aids babies, the whole paediatric ward would be blocked up and we would be stuck with patients we can’t help. Even if we put them on oxygen, they would probably only live for a month.”
Bekker, whose comments were reported in a daily Eastern Cape newspaper, is the latest in a growing list of Eastern Cape doctors and Department of Health officials to defy Bisho’s gag order on media comment and speak out on Aids policy.
The first was East London’s Cecilia Makiwane hospital public health head Dr Costa Gazi, who is also the Pan Africanist Congress health secretary, who stunned the public when he called for manslaughter charges to be brought against former health minister Nkosazana Dlamini-Zuma for her refusal to provide AZT to pregnant women.
Gazi was fined R1E000 for bringing the government into disrepute and he plans to appeal to the Public Service Commission.
Last month, Dr Linda Jones, a general surgeon at Livingstone hospital, Port Elizabeth’s busiest, said, “Throwing expensive drugs against HIV-related infections simply postpones the inevitable and, as I have now seen, assists the spread of the virus. Conversely, leaving patients without known treatment undermines my status as a treater and turns me into a rather overpaid mortuary attendant and filler-in of death certificates.”
With Bisho “groaning” under its huge health and welfare burden - a significant part of it being HIV-positive patients with Aids-related infections such as tubercolosis - Jones said the region “was having to deal with deteriorating health standards which make my job unpleasant”.
Port Alfred, Cathcart and Uitenhage provincial hospitals were described by staff this week as “pathetic”. There is a chronic food shortage at all these hospitals, with patients either having to depend on their families to supply meals or being sent home to eat. Municipal bills have gone unpaid and there are dwindling medication stocks. Severe drug shortages are also reported from East London’s major Frere and Cecilia Makiwane hospitals.
But Bisho says there is no problem, with the health department permanent secretary, Dr Siphiwo Stamper, calling the hospitals’ cashflow crisis the symptom of the government’s “cost containment measures”.
Health MEC Bevan Goqwana, who is on a trip to Cuba this week, said before his departure that his department had enough money for hospitals until the end of the financial year.
Saying state hospitals spend too much and waste too much and that administrators need to cut costs and learn business skills, Goqwana blames poor management. It is not a theory that is going down too well at Dora Nginza this week.